Organization
DOMINION SURGICAL ASSISTANTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. IRIS MARION CARLINE FERGUSON RN, RNFA (PRESIDENT)
(703) 861-7660
Entity
Organization
Contact information
Practice address
24440 STONE SPRINGS BLVD, DULLES, VA 20166
(703) 861-7660
Mailing address
25226 JUSTICE DR, SOUTH RIDING, VA 20152-6011
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
0001130352
VA
Other
Enumeration date
11/07/2017
Last updated
08/24/2018
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